Arthritis Care & Research最新文献

{"title":"Treating lupus nephritis patients to lupus low disease activity reduces renal relapse and preserves long-term kidney function.","authors":"Chak Kwan Cheung, Desmond Yh Yap, K L Lee, Philip H Li, Iris Yk Tang, Chak Sing Lau, Shirley Cw Chan","doi":"10.1002/acr.25611","DOIUrl":"https://doi.org/10.1002/acr.25611","url":null,"abstract":"<p><strong>Objective: </strong>Lupus low disease activity state (LLDAS) is a validated treatment target in systemic lupus erythematosus (SLE) but limited studies have explored the role of LLDAS in lupus nephritis (LN). This study aims to investigate the frequency and predictors of LLDAS attainment, and its benefit on LN relapse and renal function preservation in patients with LN.</p><p><strong>Methods: </strong>Patients with LN during 2010-2020 in Queen Mary Hospital and Pamela Youde Nethersole Eastern Hospital were included in the discovery cohort and validation cohort, respectively. Complete renal response (CRR), partial renal response (PRR), LLDAS, and DORIS remission were assessed at 12 months. Regression analysis was performed to identify risk factors of LN relapse. Receiver operating characteristic (ROC) curves were used to evaluate target attainment and long-term kidney function.</p><p><strong>Results: </strong>A total of 245 LN patients (discovery cohort N=143, validation cohort N=102) were included. At 12 months, 57/143 (40%), 14/143 (10%), 70/143 (49%), 15/143 (10%) patients achieved CRR, PRR, LLDAS, and DORIS remission respectively. Attainment of both CRR/ PRR and LLDAS at 12 months was associated with best relapse-free survival (p<0.001). Multivariate analysis showed independent association of CRR/PRR and LLDAS with LN relapse risk reduction (CRR/PRR: HR=0.31, p = 0.007; LLDAS: HR=0.38, p = 0.029). LLDAS attainment predicts renal function preservation with satisfactory performance in both discovery and validation cohorts (AUC-ROC=0.71).</p><p><strong>Conclusion: </strong>LLDAS is an attainable target in LN comparable to CRR/PRR. Attainment of both targets is associated with additional benefit on relapse risk reduction. Early LLDAS attainment is associated with renal function preservation.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxychloroquine Associated with Lower Glomerular Filtration Rate Decline in Lupus Nephritis.","authors":"Shivani Garg, Brad Rovin, Brad C Astor, Tripti Singh, Fauzia Hollnagel, Megan Kuik, Lexie Kolton, Callie Saric, S Sam Lim, Christie M Bartels","doi":"10.1002/acr.25616","DOIUrl":"https://doi.org/10.1002/acr.25616","url":null,"abstract":"<p><strong>Background: </strong>Hydroxychloroquine (HCQ) protects kidney function in lupus nephritis (LN) by preventing flares, yet some cohort studies show no significant benefit in kidney function with HCQ. Clarifying these conflicting findings by showing early and long-term benefits of HCQ on kidney function preservation is critical. Therefore, we analyzed data from our retrospective longitudinal inception LN cohort to examine the time-varying effects of HCQ on kidney function decline in LN.</p><p><strong>Methods: </strong>Retrospective data from an incident biopsy proven LN cohort. Creatinine values at LN diagnosis through the last follow-up were abstracted to estimate the glomerular filtration rate (eGFR). Using HCQ exposure as a time-dependent covariate, we examined associations between HCQ exposure and sustained eGFR decline ≥30% and ≥40%. We also calculated an annual eGFR slope decline by HCQ exposure using linear mixed effects analysis.</p><p><strong>Results: </strong>Among 209 patients, 33% & 23% experienced eGFR decline ≥30% and ≥40% over time. Time-varying HCQ exposure was associated with 60% and 62% lower risk of eGFR decline of ≥30% or ≥40%, after adjusting for propensity scores. An 77% lower risk of eGFR decline was noted in patients with CKD ≥3 with HCQ. HCQ exposure reduced the annual eGFR slope decline by 5.12 and 3.17 ml/min/1.73 m² within first 5 and 10 years of diagnosis.</p><p><strong>Conclusion: </strong>HCQ use was associated with early and long-term benefits on kidney function in LN, including those with CKD ≥3. Universal HCQ use should be encouraged in LN patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Apremilast for the Treatment of Immune Checkpoint Inhibitor Psoriasis and Psoriatic Arthritis.","authors":"Nilasha Ghosh, Pankti Reid, Jeffrey A Sparks, Kaitlin McCarter, Kyle Ge, Anne R Bass","doi":"10.1002/acr.25604","DOIUrl":"https://doi.org/10.1002/acr.25604","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to present effectiveness and tolerability of apremilast in a cohort of 21 patients with immune checkpoint inhibitor psoriatic arthritis (ICI-PsA) and/or immune checkpoint inhibitor psoriasis (ICI-PsO).</p><p><strong>Methods: </strong>This multicenter study combined data from patients treated with apremilast after experiencing ICI-PsO and/or ICI-PsA. Patients taking apremilast before ICI initiation and patients with preexisting autoimmune disease before ICI therapy were also included. Response to apremilast was determined as complete, partial, or none as determined by improvement in Common Terminology Criteria for Adverse Events grading after drug initiation.</p><p><strong>Results: </strong>There were 21 patients who used apremilast for either ICI-PsO and/or ICI-PsA, but only five of these patients had de novo ICI-PsO and/or ICI-PsA. Of these five patients, four had partial response or improvement in their immune-related adverse event with apremilast, although there were intolerances in three of these patients. Of the 21 total patients, 16 had a relevant preexisting autoimmune disease, indicating a likely flare of the underlying disease with ICI therapy. Flares occurred much sooner for patients with ICI-PsA (4 weeks) compared to patients with ICI-PsO only (39.7 weeks), although the majority of both groups had grade II severity. Among the 13 patients with preexisting disease and no exposure to apremilast before ICI therapy, all patients in the ICI-PsO-only group (100%) responded to apremilast with either a complete or partial response, whereas only 57% of patients in the ICI-PsA group had complete or partial response. Twenty-nine percent of patients in the entire cohort had to discontinue apremilast due to intolerability. Thirty-eight percent of the entire cohort had progression of cancer or death at last follow-up after being on apremilast.</p><p><strong>Conclusion: </strong>This study highlights the potential benefit of apremilast for the treatment of ICI-PsO, both de novo and PsO flare, with less of an apparent benefit for ICI-PsA. Thirty percent of patients in the whole group had to discontinue apremilast due to intolerance. Apremilast may be an attractive therapeutic option for either condition given that it is not immunosuppressive, but further prospective observational studies with larger patient numbers are needed.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of lung ultrasound interpretation criteria for ILD in systemic sclerosis and inflammatory myopathy: comment on the article by Fairchild et al.","authors":"Pablo Echevarría Díez-Canedo, Raquel Marín-Baselga, Yale Tung-Chen","doi":"10.1002/acr.25606","DOIUrl":"10.1002/acr.25606","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a personalized visualization and analysis tool to improve clinical care in complex multisystem diseases with application to scleroderma.","authors":"Ji Soo Kim, John Scott, Lauren Fisher, Lauren N Smith, Willie Stewart, Adrianne Woods, Rob Smithwright, Diane Koher, Parastoo Aslanbeik, Aalok B Shah, Brad Tibbils, Samantha I Pitts, Ayse P Gurses, Yushi Yang, Ana-Maria Orbai, Antony Rosen, Laura K Hummers, Scott L Zeger, Ami A Shah","doi":"10.1002/acr.25613","DOIUrl":"https://doi.org/10.1002/acr.25613","url":null,"abstract":"<p><strong>Background: </strong>In complex diseases, it is challenging to assess a patient's disease state, trajectory, treatment exposures, and risk of multiple outcomes simultaneously, efficiently and at the point of care.</p><p><strong>Methods: </strong>We developed an interactive patient-level data visualization and analysis tool (VAT) that automates illustration of a scleroderma patient's trajectory across multiple organs and illustrates this relative to a reference population, including patient subgroups who share risk factors with the index patient, to improve estimation of disease state. We conducted VAT usability testing with patients and clinicians. We then embedded results from internally cross-validated, Bayesian multivariate mixed models that calculate an individual's risk of critical events, utilizing baseline risk factors, patient-level information in past trajectories in multiple dimensions, and known outcomes from the entire population and relevant subgroups.</p><p><strong>Results: </strong>The web-based application aggregates complex, longitudinal data to illustrate patient-, subgroup- and population-level health trajectories across multiple organ systems. Patients (N=7) exposed to the VAT reported increased knowledge about their disease and confidence in medical decision-making. Rheumatologists (N=4) were able to access 8.6-times more data in 81.5% of the time using 2/3 fewer clicks using the VAT compared to the EMR. Statistical modeling was successfully embedded in the VAT, enabling real-time estimation of a patient's risks of multiple complications.</p><p><strong>Conclusions: </strong>Systematic analysis and visualization of individual- and population-level data in a complex disease has potential to improve medical decision-making and warrants further study. Individualized risk estimation disseminated at the point of care may enable targeted screening and early intervention in high-risk patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the bloodstream-rethinking colchicine monitoring through a clinical lens: comment on the article by Stamp et al.","authors":"Yadi Li, Zheng Wei, Jianlong Zhou","doi":"10.1002/acr.25605","DOIUrl":"10.1002/acr.25605","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Robert M Fairchild, Lorinda Chung","doi":"10.1002/acr.25607","DOIUrl":"10.1002/acr.25607","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Scleroderma Renal Crisis Does Occur - A Multi-Center Study.","authors":"Swati Mehta, Sumbal Wajid, Isam Albaba, Virginia Steen, Robyn T Domsic-Degazio, Alexa Luta, Paul J Feustel, Loay Salman, Lee Shapiro","doi":"10.1002/acr.25608","DOIUrl":"https://doi.org/10.1002/acr.25608","url":null,"abstract":"<p><strong>Objective: </strong>Scleroderma renal crisis (SRC) is historically described to occur within first 5 years of SSc diagnosis. However, it has been observed to occur beyond 5 years. In this analysis, we aim to describe the prevalence, clinical features and outcomes of late onset SRC and compare them to early onset SRC.</p><p><strong>Methods: </strong>This retrospective observational study included patients diagnosed with SRC between 1995 to 2018 at three university-affiliated hospitals. Late onset SRC was defined as SRC occurring 5 years after SSc diagnosis. After obtaining IRB approval, data including demographics, SRC onset, clinical characteristics, laboratory data, and outcomes were extracted. Continuous data were expressed as mean/median, and categorical as frequencies/percentages. Differences were analyzed via Pearson's chi-square.</p><p><strong>Results: </strong>A total of 223 SRC patients were identified, with 169 (75.8%) classified as early onset and 54 (24.2%) as late onset. Late onset group had a mean SRC onset at 12.2 years after SSc diagnosis. Male predominance was observed in late compared to early group (59% vs 9%). Steroid exposure was more common in late vs early group (56% vs 29%). There was no evidence of difference in autoantibodies profile and outcomes between early and late onset groups.</p><p><strong>Conclusions: </strong>Late onset SRC was seen in up to 25% of SRC patients, with a mean of 12 years after SSc diagnosis. Our findings reveal comparable clinical characteristics and outcomes between early and late onset SRC, underlying the importance of recognizing SRC regardless of disease duration to optimize outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III-C Report: Assessment of Patient Scenarios (Derivation Cohort) and Refinement of Definitions.","authors":"Medha Barbhaiya, Stephane Zuily, Deanna Jannat-Khah, Mary-Carmen Amigo, Danieli Andrade, Tadej Avcin, Maria L Bertolaccini, D Ware Branch, Nathalie Costedoat-Chalumeau, Guilherme Ramires de Jesús, Katrien M J Devreese, David Garcia, Jose A Gomez Puerta, Francis Guillemin, Steven R Levine, Roger A Levy, Michael D Lockshin, Thomas L Ortel, Michelle Petri, Giovanni Sanna, Savino Sciascia, Surya V Seshan, Maria Tektonidou, Denis Wahl, Rohan Willis, Cecile Yelnik, Alison Hendry, Ray Naden, Karen H Costenbader, Doruk Erkan","doi":"10.1002/acr.25599","DOIUrl":"https://doi.org/10.1002/acr.25599","url":null,"abstract":"<p><strong>Objective: </strong>The 2023 ACR/EULAR Antiphospholipid Syndrome (APS) Classification criteria aim to identify patients with high likelihood of APS for research. Phases I/II of our four-phase methodological approach resulted in 27 candidate criteria organized in clinical and laboratory domains. Here, we summarize Phase III efforts to reduce and refine criteria using patient scenarios.</p><p><strong>Methods: </strong>Using standardized definitions for candidate criteria, the Steering Committee collected antiphospholipid antibody (aPL)-positive cases referred for \"suspected APS\". Treating physicians assessed APS case likelihood using a Likert Scale. Poisson regression calculated risk ratios (RR) and 95% confidence intervals to quantify the direction and size of the association of candidate criteria with \"highly likely\" versus \"equivocal or unlikely\" APS, which guided Steering Committee candidate criteria refinement and organization.</p><p><strong>Results: </strong>We collected 314 suspected APS cases (137 [44%] highly likely, 177 [56%] equivocal/unlikely APS). Provoking venous thromboembolism (VTE) or arterial thromboses (AT) risk factors reduced the size of the association with highly likely APS (RR 4.31 [95%CI 2.11-8.78] to RR 1.56 [95%CI 0.89-2.75] for VTE, and RR 3.48 [95%CI 1.91-6.32] to RR 1.64 [95%CI 0.77-3.51] for AT). Persistent lupus anticoagulant, anticardiolipin IgG antibody >40U, and anti-β₂-glycoprotein-I IgG antibody >40U were positively associated with highly likely APS (all p<0.05). Eventually, items within eight additive and independent clinical and laboratory domains were refined.</p><p><strong>Conclusion: </strong>Referred suspected APS cases provided insight into associations of individual candidate criteria with APS likelihood. Risk ratio analyses helped refine items and organize the draft classification system into eight additive and independent clinical and laboratory domains.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term lignan intake, whole grain foods, and the risk of gout: results from two prospective cohort studies.","authors":"Sharan K Rai, Yang Hu, Ming Ding, Frank B Hu, Molin Wang, Jorge E Chavarro, Natalie McCormick, Hyon K Choi, Qi Sun","doi":"10.1002/acr.25596","DOIUrl":"https://doi.org/10.1002/acr.25596","url":null,"abstract":"<p><strong>Objective: </strong>Multiple plant-based dietary patterns are inversely associated with gout, although the individual constituents driving this association remain unclear. Dietary lignans, a major group of phytoestrogens abundant in plant foods, are metabolized by the gut microflora and may modulate gout risk. We examined the associations between dietary lignan intake, certain whole grain foods rich in lignans, and incident gout.</p><p><strong>Methods: </strong>We analyzed data from 122,680 individuals in the Health Professionals Follow-up Study and Nurses' Health Study. We administered a food frequency questionnaire every 2-4 years. We used Cox models to evaluate associations between dietary lignans, whole grain foods, and confirmed gout.</p><p><strong>Results: </strong>Higher intakes of matairesinol (hazard ratio [HR] and 95% confidence interval [CI] comparing extreme quintiles: 0.78 [0.69, 0.90]; P trend=0.002) and secoisolariciresinol (0.78 [0.68, 0.89]; P trend=0.002) were both associated with lower gout risk, while pinoresinol and lariciresinol were not associated with gout. We found inverse associations of whole grain cold breakfast cereals (HR for those consuming ≥1 serving/day 0.62 [0.53, 0.73]), cooked oatmeal/oat bran (HR for those consuming ≥2 servings/week 0.78 [0.70, 0.86]), and bran added to food (HR for those consuming ≥2 servings/week 0.84 [0.74, 0.95]), but not dark breads or other cooked breakfast cereals, with gout.</p><p><strong>Conclusion: </strong>Higher intakes of matairesinol and secoisolariciresinol, as well as whole grain cold breakfast cereals, oatmeal, and added bran, were each significantly associated with lower gout risk. These findings support adherence to healthful plant-based diets for gout and suggest a potential role of the gut microbiome in gout pathogenesis.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}